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October 27, 2011Emergency Medicine Journal

The prevalence and correlates of psychological outcomes in patients with acute non-cardiac chest pain: a systematic review

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Key result

Patients with non-cardiac chest pain had similar levels of anxiety, depression, and quality of life compared to patients with a cardiac diagnosis, but worse levels than healthy controls.

Why the study?

What are the prevalence and correlates of psychological outcomes in patients with acute non-cardiac chest pain accessing ED-based care?

Population

Patients with acute non-cardiac chest pain (NCCP) accessing ED-based care (12 papers reporting 10 studies)

Design

Systematic_review

Authors

RWRosemary A. WebsterAptiv (United States)PNPaul NormanUniversity of LeedsSGSteve GoodacreUppsala University

Discussion

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Implication

NCCP patients merit psychological evaluation akin to cardiac cases; confirms comparable morbidity and extends comparisons to healthy controls.

Key Points

  • This review aims to investigate the psychological outcomes of patients with non-cardiac chest pain in emergency departments and identify related factors.
  • Conducted a systematic review of 12 papers covering 10 studies focusing on psychological outcomes and correlates in NCCP patients.
  • Analyzed various outcome measures related to anxiety, depression, and quality of life in NCCP patients compared to cardiac patients and healthy controls.
  • Evaluated factors such as gender, age, psychiatric history, and specific symptoms linked to poorer psychological outcomes.
  • NCCP patients exhibited anxiety and depression levels comparable to those with cardiac diagnoses but worse than healthy controls.
  • Key factors associated with poorer psychological outcomes included gender, age, previous psychiatric history, and fears such as fear of dying.
  • The studies analyzed revealed considerable heterogeneity in design and outcome measures.

Study Design

Type

Systematic Review

Structured PICO

What are the prevalence and correlates of psychological outcomes in patients with acute non-cardiac chest pain accessing ED-based care?

P
Population
Systematic review of 10 studies evaluating psychological outcomes in patients with non-cardiac chest pain accessing emergency department-based care.
C
Comparator
Patients who received a cardiac diagnosis for their pain, and healthy controls
O
Outcome
Psychological outcomes (anxiety, depression, quality of life) and their correlatespatient reported

Patients with non-cardiac chest pain experience significant psychological morbidity comparable to those with cardiac diagnoses, highlighting the need for targeted psychological assessment and support.

Limitations

  • The studies were heterogeneous, with a variety of outcome measures, designs and settings.
  • Heterogeneous studies
  • Variety of outcome measures, designs and settings

Cite This Study

Webster et al. (2011) conducted a systematic review in Non-cardiac chest pain. Non-cardiac chest pain vs. Cardiac diagnosis or healthy controls was evaluated on Psychological outcomes (anxiety, depression, quality of life). Patients with non-cardiac chest pain had similar levels of anxiety, depression, and quality of life compared to patients with a cardiac diagnosis, but worse levels than healthy controls.

synapsesocial.com/papers/6a2bdc19f816d8ce9df4ec43https://doi.org/10.1136/emermed-2011-200526
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Psychological morbidity and illness appraisals of patients with cardiac and non-cardiac chest pain attending a rapid access chest pain clinic: a longitudinal cohort study2007 · 59 citations
  2. 2Natural history and predictors of outcome for non‐cardiac chest pain: a prospective 4‐year cohort study2008 · 99 citations
  3. 3Anxiety disorder in patients with non-specific chest pain in the emergency setting2006 · 47 citations
  4. 4Use of the Hospital Anxiety and Depression Scale (HADS) in a Cardiac Emergency Room – Chest Pain Unit2009 · 60 citations
  5. 5Psychological interventions for symptomatic management of non-specific chest pain in patients with normal coronary anatomy2015 · 159 citations